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Asthma

Asthma in Baltimore

The City of Baltimore is burdened by asthma. According to the Maryland Department of Health and Mental Hygiene, 12.4 % of Baltimore City adults currently have asthma, compared to 8.4% statewide and 8.6 % nationally. Baltimore City children under 18 years of age also have more than their fair share of asthma, with an asthma prevalence more than twice the national average – 20% vs. 9.4% respectively. Baltimore’s pediatric asthma hospitalization rate is the highest in Maryland and one of the highest in the nation. Asthma accounts for the greatest loss of productivity either through missed work days or school absenteeism. Nationally, it is estimated that 10 million work days and almost 14 million school days are missed each year due to asthma.

What is Asthma?

Asthma is a chronic disease of the airways – the tubes that bring air in and out of your lungs – that can make it hard to breathe. People with asthma have airways that are sensitive to things called triggers. Triggers cause the airways to swell and fill up with mucus, and make the muscles around the airways tighten. This can cause coughing, wheezing, chest tightness, and trouble breathing. Everyone's asthma triggers are different, so it is important to know what your triggers are. Asthma cannot be cured, but it can be controlled! Seeing your doctor, taking your medication, and avoiding triggers are all ways you can manage your asthma.

When asthma is under control a person can be active, feel good, and sleep through the night. When your asthma is controlled you:

Have few asthma symptoms even after exercise and at night

Have few asthma attacks

Do not miss school or work

Can exercise without symptoms

Have no emergency room visits or hospital stays

Use quick-relief medicine (albuterol) fewer than twice per week during the day or twice per month at night

Asthma that is not well controlled can lead to many school or work absences, emergency room visits, and hospitalizations.

What Can You Do?

There are things you can do to manage asthma:

Know the early signs of worsening asthma so you can take your medicine or contact your doctor and prevent a serious attack

Keep your Asthma Action Plan available

Know how to respond to an asthma episode

Use your medicine as prescribed by your doctor

Use a spacer when using a Metered Dose Inhaler

Keep your rescue medicine in the school health suite

Know your asthma triggers and avoid them

See your doctor regularly

How to Respond to an Asthma Episode

If, despite doing everything you can to manage the asthma, your child still has an asthma episode, you should do the following:

Stop all activity, and help to sit up

Follow the steps outlined in the Asthma Action Plan

Help the child use his/her inhaled quick relief medication:

1 spray, wait one minute, repeat

Get emergency help if child fails to improve within a few minutes.

Call 911 if child is hunched over; struggling to breathe, talk, or stay awake; or has blue lips/fingernails

Recognizing Signs and Symptoms

It is important to know your asthma signs and symptoms. Relief medication works best when it is taken as soon as symptoms appear. Common signs include:

Shortness of breath

Wheezing

Coughing

Chest tightness

Other signs can include:

Feeling sweaty / getting sudden chills

Feeling edgy for no reason

Funny feeling in chest or throat

Feeling tired even after sleeping

Itchy chin or neck

Chronic cough

Asthma Medications

It is important to work with your doctor to find the right medicines that will control asthma symptoms. There are two kinds of asthmamedicines:

Controller (daily) medication that:

Reduces airway swelling

Prevents symptoms

Should be taken daily, even if feeling ok

Can take up to two weeks to work

Relief (or rescue)medication that:

Relaxes airway muscles and opens the airway

Relieves symptoms

Is taken when symptoms first develop or before encountering a trigger

Asthma Triggers

An asthma trigger is anything that makes your asthma worse. It is important to know what triggers your asthma and take steps to reduce those triggers. Since asthma can be triggered by the things you are allergic to, you may want to talk to you doctor about testing for allergies.

Some common triggers are:

Tobacco and other smoke

Dust mites

Pets with fur or feathers

Bleach (or other cleaners with strong smells)

Air fresheners

Perfumes

Chalk dust

Pollution

Mold

Pollen

Pests such as cockroaches and mice

Cold, dry weather

Warm, damp weather

Colds & flu

Strong emotions or stressful situations

Asthma Action Plan

Your doctor can help you remember what to do by filling out an Asthma Action Plan. The Asthma Action Plan is a form that explains what medicine to take for asthma and when to take it. You should give a copy of the Asthma Action Plan to everyone who cares for your child.

Baltimore City Public Schools have their own School Health Asthma Action Plans. These forms can be obtained in the school s Health Suite and should be completed and signed by your health care provider, and a copy given to the school nurse or health aide. These forms let the school know what and how much medicine to give your child in the event of an asthma attack.

What Services Does BCHD Provide?

Home Visiting Services

The Community Asthma Program (CAP) is enrolling Baltimore City children ages 1 to 18 who have trouble managing their asthma. Home visits from trained community health workers help families improve asthma control by:

Going over medications prescribed by your doctor

Showing proper medication technique

Helping obtain an Asthma Action Plan from your doctor

Showing you where asthma triggers are in your home

Giving supplies to reduce asthma triggers in the home

Connecting you to other services that might help

Home visiting services can be requested by calling 410-396-3848, or by faxing the referral form to 410-244-1366.

Community Education

CAP also provides interactive asthma education to community groups, parent groups, children, and care providers. Education is tailored to group needs. To request asthma education for a group, please call 410-396-3896, or fax the referral form to 410-244-1366.